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Effect on mortality of treatment method and surgery time for hip fracture patients aged over 65 years
Cihat Ekici1, Özhan Pazarcı1, Seyran Kılınç1
1Department of Orthopaedics and Traumatology, Cumhuriyet University Faculty of Medicine, Sivas-Turkey.
Insights
For hip fracture patients over 65, implant selection significantly impacts survival, with cemented hemiarthroplasty showing better outcomes. Early surgery within 48 hours did not affect mortality rates.
Area of Science:
- Orthopedic Surgery
- Geriatric Medicine
- Trauma Surgery
Background:
- Hip fractures are common in patients over 65.
- Surgical intervention is standard treatment.
- Mortality is a key concern in this demographic.
Purpose of the Study:
- To evaluate the impact of implant selection on mortality in elderly hip fracture patients.
- To assess the effect of time to surgery on survival rates.
Main Methods:
- Retrospective analysis of 242 patients aged over 65 with hip fractures.
- Patients were grouped by surgical implant: cemented hemiarthroplasty (CH), cementless hemiarthroplasty (CLH), and proximal femoral nail (PFN).
- Survival data was analyzed in relation to implant type and time to surgery.
Main Results:
- No significant difference in survival was found between early (<48 hours) and delayed surgery.
- Implant selection significantly affected patient survival (p=0.016).
- Patients receiving cemented hemiarthroplasty demonstrated longer survival compared to cementless hemiarthroplasty and proximal femoral nail groups.
Conclusions:
- Early surgical intervention for hip fractures in the elderly does not influence mortality.
- Implant choice is a critical factor affecting survival.
- Age and sex also play a role in mortality outcomes for hip fracture patients.
Background:
This study aimed to evaluate the effects on mortality of implant selection used and time to surgery in patients aged over 65 years operated for hip fractures.
Methods:
A total of 301 patients aged over 65 years were investigated in this study. Patients were divided into three groups as follows: Group 1 cemented hemiarthroplasty (CH), Group 2 cementless hemiarthroplasty (CLH), and Group 3 proximal femoral nail (PFN). Time of surgery, fracture and demographic information were retrospectively recorded.
Results:
After removing 59 patients with missing information, this study included 242 patients. Mean age of patients was 80.5 years. When patient groups were examined according to treatment method, Group 1 (n=146) comprised 60.3%, Group 2 (n=54) comprised 22.3% and Group 3 (n=42) comprised 17.4% of the study group. There was no significant difference in survival between the patients operated in the first 48 hours and the patients operated later (p=0.834). There was an effect on the survival of treatment implant selection (p=0.016). Patients with CH were observed to survive longer than patients with CLH and PFN.
Conclusion:
Operation in the first 48 hours was not observed to affect mortality. Additionally, while sex and age were found to be effective on mortality, implant selection was also concluded to affect mortality.
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